Unlocking policy synergies, challenges and contradictions influencing implementation of the Comprehensive Sexuality Education Framework in Zambia: a policy analysis

Health Research Policy and Systems

Research

Isabel Goicolea¹  Anna-Karin Hurtig¹  Malizgani Paul Chavula²  Joseph Mumba Zulu³ 

[1] Department of Epidemiology and Global Health, Umeå University, 901 87, Umeå, Sweden;Department of Epidemiology and Global Health, Umeå University, 901 87, Umeå, Sweden;Department of Health Policy Management, Promotion and Education, School of Public Health, The University of Zambia, Box 50110, Ridgeway Campus, Lusaka, Zambia;Department of Health Policy Management, Promotion and Education, School of Public Health, The University of Zambia, Box 50110, Ridgeway Campus, Lusaka, Zambia;

关键词: Comprehensive sexuality education;    Sexual reproductive health rights;    Policy analysis;    Facilitators;    Challenges;    Adolescents;   

DOI  :  10.1186/s12961-023-01037-y

 received in 2023-06-06, accepted in 2023-08-05,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundComprehensive sexuality education (CSE) has recently become salient, but adolescent sexual reproductive health and rights (ASRHR) challenges are still a global health problem. Studying policies which have implications for CSE implementation is a crucial but neglected issue, especially in low and middle-income countries (LMICs) like Zambia. We analyzed policy synergies, challenges and contradictions influencing implementation of CSE framework in Zambia.MethodsWe conducted a document review and qualitative interviews with key stakeholders from Non-Governmental Organizations, as well as health and education ministries at the National and all (10) provincial headquarters. Our methods allowed us to capture valuable insights into the synergies, challenges and contradictions that exist in promoting CSE framework in Zambia.ResultsThe study highlighted the synergies between policies that create opportunities for implementation of CSE through the policy window for adoption of sexual reproductive health and rights (SRHR) that opened around the 1990s in Zambia, promotion of inclusive development via education, adoption of an integrated approach in dealing with SRHR problems, and criminalization of gender-based violence (GBV). This analysis also identified the policy challenges and contradictions including restricted delivery of education on contraception in schools; defining childhood: dual legal controversies and implications for children, grey zones on the minimum age to access SRHR services; inadequate disability inclusiveness in SRHR legal frameworks; policy silences/contentious topics: LGBTQI + rights, abortion, and grey zones on the minimum age to access SRHR services.ConclusionWhile many policies support the implementation of CSE in schools, the existence of policy silences and challenges are among the barriers affecting CSE implementation. Thus, policy reformulation is required to address policy silences and challenges to enhance effective promotion and integration of the CSE framework.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023